# Does the placebo effect work if you know there's a placebo effect? **URL:** \ **Category:** Factual Questions\ **Created:** [April 26, 2009, 10:08am UTC](https://boards.straightdope.com/t/does-the-placebo-effect-work-if-you-know-theres-a-placebo-effect/494392 "2009-04-26T10:08:29Z")\ **Posts on this page:** 9\ **Page:** 2
**Author:** ![Harriet\_the\_Spry](https://avatars.discourse-cdn.com/v4/letter/h/e56c9b/32.png) [@Harriet\_the\_Spry](https://boards.straightdope.com/u/Harriet_the_Spry)\ **Post date:** [April 26, 2009, 7:49pm UTC](https://boards.straightdope.com/t/does-the-placebo-effect-work-if-you-know-theres-a-placebo-effect/494392/21 "2009-04-26T19:49:10Z")
> [@74westy](#): > > As to the ethics of placebos, remember that effective treatments have as much placebo effect as ineffective ones and also include of the real effect. I think this is the key to the OPs question. Most adults today in the US have heard of the placebo effect. We do clinical trials without trying to screen out people who are aware of the placebo effect. We tell people they may receive an active medicine or a placebo. We present it to them trying to make everyone think they are getting the active medicine. The medicine’s effect is the difference between the placebo and the active medicine group. We would expect to see a difference between the placebo group and some other group monitored only for spontaneous remission. ---
**Author:** ![constanze](https://avatars.discourse-cdn.com/v4/letter/c/f9ae1b/32.png) [@constanze](https://boards.straightdope.com/u/constanze)\ **Post date:** [April 26, 2009, 8:43pm UTC](https://boards.straightdope.com/t/does-the-placebo-effect-work-if-you-know-theres-a-placebo-effect/494392/22 "2009-04-26T20:43:04Z")
> [@Hypnagogic\_Jerk](#): > > But since homeopathic medicines are basically placebos, which you recognize, then surely they could only work for those 30 to 40% of people who believe they work, no? Since I don’t believe in the effectiveness of homeopathic medicine, there is no point in prescribing it to me. So you tell your doctor from the start that you don’t want homeopathy, and he gives you paracetamol instead. The next person hasn’t heard anything about homeopathy, and so the doctor asks them what kind of treatment they want. The third person is a new-age type against all chemical stuff and insists on homeopathy because it’s less harmful to the body. So the doctor works together with the patient individually instead of treating everybody according to established science (although established science itself says that people are much more different than just one standard body). > [@](#): > > On the other hand, I do believe that herbal remedies may contain active ingredients and have an effect above the placebo effect, and there is some scientific evidence of this. (They can also have side effects and cause bad interactions with other products, like refined pharmaceuticals can.) Which is what I said above, and the reason they are properly researched and properly prepared. > [@](#): > > You also seem to believe doctors should prescribe placebos (including homeopathic pills) as a way to avoid negative side effects from pharmaceuticals. While it is true that these effects happen, I think it’s up to the doctor and patient together to decide whether it’s worth taking the risk. Maybe in some cases a placebo is indicated, but I’d rather see a doctor educate their patient than save medicine “for later” in case a placebo doesn’t work. I’ll try again. Example 1: You have a headache. The doctor checks that there is no serious cause (tumor, whatever), it’s not a migraine. You can either take Aspirin or similar and run the risk of side effects, or take homeopathy because you believe in starting soft and escalating. If e.g. you take Aspirin and get stomach problems, you have to switch to a different medication, too. You “loose time”, too. Example 2: you have a degenerative, incurable disease like rheumatism or arthritis. You don’t want side effects like liver damage, so you take herbal medicine. It has been checked to be not harmful as long as you don’t combine it with X, but you don’t know if there are active ingredients that actually work. But Hildegard of Bingen has written that this herb was a great success in her cures, so you try it. Example 3: You have a cold. You don’t believe in any natural stuff, you don’t want placebos. Your doctor gives you paracetamol for the pain and some other throat tablets. After one day, your throat is still killing you, and the fever/headache doesn’t let you sleep. So the doctor switches you from paracetamol to another active ingredient. Again, you’ve “lost time”. So? With a cold, you have to wait 7 days with rest and fluids anyway. The medication simply lessens the symptons, it doesn’t cure you at all. > [@](#): > > And why would Aspirin cause a nocebo effect? Because people expect it to upset their stomach and cause them to bleed? No, because everything causes a placebo effect in some persons, and a nocebo effect in some others. It’s simply the power of belief the other way - people who believe that chemicals are dangerous (and given the thick book about side effects , unexpected cross effects, damage and even deaths from wrong medication each year - officially approved, active ingredient medication at that - that fear is not complelty tin-foil, only exaggerated. > [@](#): > > Interestingly enough, if I remember a research on homeopathy I did in high school well (it’s been a long time), homeopathy was actually invented by a physician who wanted to bring medicine into the realm of science. He noticed that some pharmaceuticals (quinine is an example, I believe) can, in large doses, cause the effect that they would counter if administered in small doses. He speculated that other chemicals could do the same. Yes, Samuel Hahnemann was a physician, and yes he observed a true effect, and no, there’s no evidence that this applies to all plants. ---
**Author:** ![Rigamarole](https://avatars.discourse-cdn.com/v4/letter/r/77aa72/32.png) [@Rigamarole](https://boards.straightdope.com/u/Rigamarole)\ **Post date:** [April 26, 2009, 8:54pm UTC](https://boards.straightdope.com/t/does-the-placebo-effect-work-if-you-know-theres-a-placebo-effect/494392/23 "2009-04-26T20:54:00Z")
> [@glee](#): > > And just to repeat again - buying copper bracelets (for any price) doesn’t help any more than any other placebo. And it stops people getting proven medical treatment. It doesn’t always stop them from getting proven treatment. I remember from a National Geographic video I watched once about shamans/witch doctors they followed one of these shamans from South America who at some point developed an illness. They noted that “he was not against conventional medicine” and showed him going to a hospital and getting a doctor’s advice and treatment. Then they went on to add “but he likes to hedge his bets”, and showed him doing his crazy voodoo ritual chanting and dousing himself in chicken blood. If that increases his belief in the effectiveness of the overall treatment process, so be it. It’s a small point, but quackish remedies and modern medicine are not always mutually exclusive. ---
**Author:** ![constanze](https://avatars.discourse-cdn.com/v4/letter/c/f9ae1b/32.png) [@constanze](https://boards.straightdope.com/u/constanze)\ **Post date:** [April 26, 2009, 9:02pm UTC](https://boards.straightdope.com/t/does-the-placebo-effect-work-if-you-know-theres-a-placebo-effect/494392/24 "2009-04-26T21:02:04Z")
> [@glee](#): > > ‘Very unique’ huh? I do not think that word means what you think it means! 😉 > > My dictionary defines ‘medicine’ as: > > 1. science or practice of diagnosis, treatment and prevention of disease … > 2. any drug or preparation used for the treatment or prevention of disease … > 3. a charm, spell or fetish, which is thought to clear afflictions … > > So I’ll accept that homeopathy is ‘medicine’, just like going to a witch doctor or a wizard is ‘medicine’. Because it fits definition 2 in those cases where it works. > [@](#): > > It has no place in a modern society. Again, are you against all placebos under any circumstances in the real treatment (That is outside clinical tests)? Yes or no? I’ll repeat again so you don’t misunderstand me: I’m NOT advocating using homeopathy or other placebos ACROSS THE BOARD indiscrimnatly. I am FOR using placebos and natural methods even if their effectivness is not yet proven (as long as bad effects are ruled out) IN CERTAIN CASES like colds, headaches and degenerative diseases. > [@](#): > > It is wrong if it costs money, or prevents someone getting a proven medical treatment. Please explain what the proven medical treatment for a cold or headaches or a degenerative disease is that goes beyond treating the pain symptoms? I don’t know of any real cure. And by your own earlier post, stopping pain is what placebos do for some people. Again, maybe you could answer my question: do you prefer more people to risk side effects from active chemical ingredients because you are against placebos? Again, taking an aspirin against pain can DELAY medical treatment like surgery because of the blood-thinning property. > [@](#): > > Please look at what you’re saying! > > **Is homeopathy a genuine treatment or a placebo?** > > Its practitioners claim it really works, even though there is no evidence it’s genuine. Huh? I didn’t say that at all. But for the record: yes, I personally think it’s only placebo effect. But for its followers, it works quite well. Personally, I don’t care if it’s “only” the placebo effect instead of a “proven” direct mechanism, AS LONG AS IT WORKS. > [@](#): > > **If it’s merely a placebo, why bother to go to all the trouble of diluting different substances?** > Why charge any money at all? Because that’s what makes it effective for its followers. If you give a bottle of water for free, there is no placebo effect. In your link to the BBC site, it said that studies had shown that big pills work better than small pills, and colourful pills better than white ones for the placebo effect. And paying money is also part of the placebo effect. According to you, every patient should be given effective medicine right away. Do you think pharma companies give them away for a dime? Actually, your approach is more expensive than trying homeopathy first and giving the more expensive (because more costly to produce) real medicine only where necessary. > [@](#): > > Actually **you** don’t understand the placebo effect. It can be triggered by: > > - a sugar pill > - a sympathetic bedside manner > - an assurance that the patient just needs rest > - a psychic telling you the spirits will help > - meditation You do know that scientific studies have shown measureable things like decrease in blood pressure (related to heart diseases) in people who meditate regularly, do you? Since you earlier claimed that placebos only affect pain because it’s subjective, that’s not placebo. > [@](#): > > - Tibetan chanting > - copper bracelets > - Hopi ear waxing Actually, after Cecil’s article on ear candles, that they can cause real harm, I’m against them. Placebos and other methods should either work or not work, but not cause harm. > [@](#): > > So any trial of copper bracelets would be against the list above. Placebo v placebo (except one costs money). I repeat what I said: the test of the placebo effect would be copper bracelets against proven medicine. I never said to test copper bracelets vs. placebo. > [@](#): > > And just to repeat again - buying copper bracelets (for any price) doesn’t help any more than any other placebo. And it stops people getting proven medical treatment. And to repeat again, what proven medical treatment cures degenerative diseases like rheuma and arthritis? ---
**Author:** ![glee](https://avatars.discourse-cdn.com/v4/letter/g/b5a626/32.png) [@glee](https://boards.straightdope.com/u/glee)\ **Post date:** [April 27, 2009, 2:17am UTC](https://boards.straightdope.com/t/does-the-placebo-effect-work-if-you-know-theres-a-placebo-effect/494392/25 "2009-04-27T02:17:34Z")
> [@glee](#): > > My dictionary defines ‘medicine’ as: > > 1. science or practice of diagnosis, treatment and prevention of disease … > 2. any drug or preparation used for the treatment or prevention of disease … > 3. a charm, spell or fetish, which is thought to clear afflictions … > > So I’ll accept that homeopathy is ‘medicine’, just like going to a witch doctor or a wizard is ‘medicine’. > [@constanze](#): > > Because it fits definition 2 in those cases where it works. There is a clear difference between medicine that works and the placebo effect (or spontaneous remission). (The success rate is higher, for starters.) Any placebo (including homeopathy) is definition 3. > [@glee](#): > > It has no place in a modern society. > [@constanze](#): > > Again, are you against all placebos under any circumstances in the real treatment (That is outside clinical tests)? Yes or no? I don’t want anyone using real medicine without using clinical trials. I don’t want anyone selling stuff they know is just a placebo, but claiming it actually works. (You said yourself that a price of $100 was a scam.) > [@constanze](#): > > I’ll repeat again so you don’t misunderstand me: I’m NOT advocating using homeopathy or other placebos ACROSS THE BOARD indiscrimnatly. I am FOR using placebos and natural methods even if their effectivness is not yet proven (as long as bad effects are ruled out) IN CERTAIN CASES like colds, headaches and degenerative diseases. Who said you were advocating that? 😕 Given that homeopathic practioners have claimed they can cure arthritis, rheumatism and cancer (not using the placebo effect - they claim it actually works like real medicine), I think they should be stopped. And what is a ‘natural’ method? > [@constanze](#): > > Again, maybe you could answer my question: do you prefer more people to risk side effects from active chemical ingredients because you are against placebos? Please point out where I said I was against placebos. I’m against homeopathy claiming it’s real medicine; I’m against placebos being sold at expensive rates. > [@glee](#): > > **Is homeopathy a genuine treatment or a placebo?** Huh? I didn’t say that at all. But for the record: yes, I personally think it’s only placebo effect. But for its followers, it works quite well. Personally, I don’t care if it’s “only” the placebo effect instead of a “proven” direct mechanism, AS LONG AS IT WORKS. [/quote] **If you agree homeopathy is a placebo, then why the f\*ck is there training in diagnosing which homeopathic cure to use?** Why does anyone bother to make different types of homeopathic cure? Why does anyone charge money to use them? They are all placebos - just give them sugar water! [This site really sums up homeopathy](http://www.cancerhelp.org.uk/help/default.asp?page=251#cost): - This page tells you about homeopathy for people with cancer - Homeopathic remedies are made from plant, mineral and animal substances. They are diluted and shaken vigorously many times until there is little, if any, of the original substance left. Homeopaths believe that the original substance somehow leaves a molecular ‘blueprint’ in the water that triggers your body’s healing mechanisms - More than 100 published clinical trials have looked at how well homeopathy works in treating various illnesses and symptoms. None of these trials provide us with any scientific evidence to prove that homeopathy can cure or prevent any type of disease, including cancer - On your first visit, your homeopath will ask you some general questions about your health, lifestyle, diet and medical history. They will probably ask about sleep patterns, your mood and emotions. This information helps the homeopath decide on the best remedy for you. The consultation usually lasts about 45 minutes. Further appointments may be shorter, perhaps only half an hour - Your first consultation with a private homeopath will usually cost between £35 and £90. It may be even more than this, especially if the homeopath is also medically trained. Further appointments are usually shorter so cost less – about £20 to £60 - It is very important that you have homeopathic treatment from a qualified therapist ---
**Author:** ![constanze](https://avatars.discourse-cdn.com/v4/letter/c/f9ae1b/32.png) [@constanze](https://boards.straightdope.com/u/constanze)\ **Post date:** [April 27, 2009, 6:48pm UTC](https://boards.straightdope.com/t/does-the-placebo-effect-work-if-you-know-theres-a-placebo-effect/494392/26 "2009-04-27T18:48:00Z")
It seems we have to agree to disagree. I want a doctor who is concerned with helping his patients get better first, and not following one ideology, as different from a scientist is concerned with finding out the “truth” above all. I therefore want the doctors to use harmless methods if it helps their patients, instead of insisting that only “proven” treatment is used. I also want scientists to follow the proper route of observing things first, instead of declaring upfront “Well, I don’t understand how this can work, so it can’t work, so we won’t use it”. When a study shows that Yoga and other meditation lowers the blood pressure (an objectivly measurable point, unlike pain which you dismissed as being too subjective) significantly (from what I recall, they did it over a period of 6 months), then I don’t care if the scientists can explain the mechanism or not, as long as they proved it works. It doesn’t matter to me if it’s the chi traveling through the body, or if the body is producing its own chemicals in reactin to a change in the brain. If a herb has been proven to be not harmful, and has a long history of being used for one illness, then I don’t care if the scientists have found the time to isolate and identify one real active ingredient in the hundreds of different things the plant contains; or if it doesn’t have an active ingredient. If it doesn’t cause harm, then I want it to be used. ---
**Author:** ![dracoi](https://avatars.discourse-cdn.com/v4/letter/d/90db22/32.png) [@dracoi](https://boards.straightdope.com/u/dracoi)\ **Post date:** [April 27, 2009, 8:56pm UTC](https://boards.straightdope.com/t/does-the-placebo-effect-work-if-you-know-theres-a-placebo-effect/494392/27 "2009-04-27T20:56:16Z")
> [@glee](#): > > **If you agree homeopathy is a placebo, then why the f\*ck is there training in diagnosing which homeopathic cure to use?** > Why does anyone bother to make different types of homeopathic cure? > Why does anyone charge money to use them? I don’t have much of an opinion on this one way or the other, but all of these things would enhance/create a placebo effect. They’re not evidence that homeopathy works. ---
**Author:** ![Bad\_Astronaut](https://avatars.discourse-cdn.com/v4/letter/b/e19adc/32.png) [@Bad\_Astronaut](https://boards.straightdope.com/u/Bad_Astronaut)\ **Post date:** [April 27, 2009, 11:01pm UTC](https://boards.straightdope.com/t/does-the-placebo-effect-work-if-you-know-theres-a-placebo-effect/494392/28 "2009-04-27T23:01:45Z")
Also, just because 30% of the placebo group had positive results in a study, that does not mean that it was caused by any kind of mental suggestion effects. In many cases people simply get better on their own thanks to the built-in healing mechanisms in the body. In those cases it wouldn’t have made any difference if they had never sought out treatment at all, placebo or not. ---
**Author:** ![Markxxx](https://avatars.discourse-cdn.com/v4/letter/m/5daacb/32.png) [@Markxxx](https://boards.straightdope.com/u/Markxxx)\ **Post date:** [August 6, 2009, 11:50pm UTC](https://boards.straightdope.com/t/does-the-placebo-effect-work-if-you-know-theres-a-placebo-effect/494392/29 "2009-08-06T23:50:08Z")
> [@Elysian](#): > > So I’m wondering…now that I know that branded medications work exactly as the unbranded ones, will I still get the placebo effect? If I take Exedrin instead of acetaminophen, will they work the same? Actually I’d be very interested if you’d do. You should try and let us know how it works Just so you know though Excedrin is a combo med and there are differnt forumlas with various amounts of meds in them. For instance, Excedrin can contain aspirin as well as acetaminophen so you have to make sure it’s the same thing. Reminds me of when I was in my 20s and tried to give up coffee. I got bad headaches and only Anacin seemed to help. Of course I found out Anacin had caffeine in it while plain old aspirin didn’t 🙂 [Previous page](https://boards.straightdope.com/t/does-the-placebo-effect-work-if-you-know-theres-a-placebo-effect/494392.md?page=1)